DESCRIPTION: Increasing the regular use of Pap testing by underserved populations has been identified as a national priority. Southeast Asian immigrants to the United States are socially disadvantaged, have high rates of invasive cervical cancer, and demonstrate low use of Pap testing compared to other groups. However, little information concerning the control of cancer in Southeast Asian populations is available. The overall goal of the proposed research is to increase the uptake of cervical cancer screening by women from Cambodia. Specific study objectives are to obtain qualitative and quantitative information about the Pap testing behavior of Cambodian refugees; develop, implement and evaluate the effect of a culturally appropriate, neighborhood-based, cervical cancer control intervention program; and assess the feasibility and costs of the intervention components. Study participants will be Cambodian women aged 18 years and older who reside in Seattle. The PRECEDE framework and ethnographic methods will be used to develop educational materials, intervention components, and a quantitative survey instrument. The project will emphasize community involvement in all aspects of intervention development and implementation. Delivery of the intervention program will be guided by the Indigenous Model, and all interventions will be provided by bicultural outreach workers. Program components will include home visits and small group meetings, logistics assistance, and the use of videotapes and print materials. Methods for intervention development and implementation would be applicable to other non-acculturated immigrant groups. A randomized controlled trial will be employed to evaluate the effect of the intervention program. Forty South Seattle "small neighborhood areas" will be randomized to experimental or control groups. A total of 400 women will participate in the trial. The outcome variable of interest will be Pap testing during the 12-month intervention period. Pre- and post-intervention surveys will be conducted in the experimental and control areas. In addition, self-reported Pap testing will be verified by medical record review. Process measures will be examined, and the costs of the intervention program systematically assessed.